مقاله انگلیسی رایگان در مورد ترکیب درمان شناختی رفتاری با واقعیت مجازی برای درمان افسردگی – هینداوی ۲۰۲۱

Abstract

Introduction

Objectives

Methods

Results

Discussion

Data Availability

Ethical Approval

Consent

Conflicts of Interest

Acknowledgments

Supplementary Materials

References

Abstract

     Postnatal depression (PND) is a mood disorder with potentially devastating effects to the individual on many levels. It can affect cognitive functioning, motivation, and self-esteem. The person can socially withdraw from their immediate familial or social circle. It can affect bonding and quality time between the mother and baby. There are many effective therapeutic treatments used for the treatment of PND such as cognitive-behavioural therapy (CBT) and interpersonal psychotherapy (IPT). This study using a single-case study trial with 15 participants investigates the clinical usefulness of combining CBT with virtual reality (VR). Results show that the combination of CBT with VR is an effective treatment for PND. In addition, VR can enhance awareness, decision-making, and self-appreciation within the individual and can also have real-life applications. This study also shows that the combination of VR and CBT is feasible, while the use of such a technology is well accepted.

Introduction

     Postnatal depression (PND) is a mental health issue which is frequently experienced by mothers and fathers in the postpartum period [1]. It is a depressive disorder and is characterised by symptoms such as low mood, low motivation, feelings of hopelessness, being tearful, feeling unsupported, and negative self-esteem, amongst others [2]. It can have devastating effects on the individual but also on the family if undiagnosed or left untreated.

     Recently, institutions and health systems have started paying close attention to this frequently experienced mental phenomenon and have started implementing measures for providing adequate treatment to the individuals and families directly affected.

     There are different psychological treatments used for PND. The two most prominent ones are cognitive-behavioural treatment (CBT) and interpersonal psychotherapy (IPT) which are effective in treating PND in the mild to moderate range [3]. CBT can be delivered successfully in a brief and structured way, and it can have good therapeutic outcomes on people with depression in the postpartum period [4]. In addition, other treatments can be very successful and are used frequently such as person-centered counselling, group therapy, couple’s therapy, solution-focused brief psychotherapy, eye movement desensitization and reprocessing, psychodynamic psychotherapy, and dialectical behavioural therapy [5].

     The use of virtual reality (VR) has proven effective and clinically useful in the treatment of various psychological problems, especially anxiety disorders [6]. The Institute for Cognitive and Clinical Neurosciences at Monash University has been conducting promising research on the effect of VR on addictions such as gambling [7]. They use reverse engineering to train the users of the virtual environment to identify the cues that trigger their gambling behaviour. Reverse engineering is the process where a product is copied and analysed to obtain more precise information about it that is unavailable otherwise, or to recreate the product itself [8]. Other research defines reverse engineering as the breakdown of a system which helps us understand better about its functioning, complex issues surrounding it, to recover information, and to identify any side effects [9].

Results

     First, for better statistical power, all 11 participants who completed the trial were combined. Figure 3 shows the results from the questionnaires Kessler-10, GAD-7, and EPDS. &ey include the baseline, the posttreatment, and follow-up periods. All three questionnaires show a clear reduction in the posttreatment and follow-up periods following the baseline time frame. Table 6 includes the mean values and standard deviations of the same three questionnaires in the three different time periods.

     The Cohen-d test (see Table 7) shows that the differences in the mean values in all questionnaires and in all in-between comparisons between timeframes are large with one exception being medium. For example, in the comparison between baseline vs. posttreatment in Kessler-10, the d estimate is medium with a 95 percent confidence interval. However, comparing the posttreatment vs. follow-up in the same questionnaire, the d estimate is considered large. In the GAD-7 questionnaire, the d estimates when comparing baseline vs. posttreatment and posttreatment vs. follow-up are both large with a 95 percent confidence interval. Similarly, the d estimates between baseline and posttreatment, and posttreatment and follow-up for the Kessler-10 questionnaire are both estimated large with a 95 percent confidence interval.